Journal of Surgery Concepts & Practice ›› 2024, Vol. 29 ›› Issue (03): 197-205.doi: 10.16139/j.1007-9610.2024.03.03

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Diagnosis, treatment and full-process surveillance of early rectal cancer

LAN Ping(), CHEN Yongle, HE Xiaosheng   

  1. Department of General Surgery (Colorectal Surgery), Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Biomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-sen University; State Key Laboratory of Onco-logy In South China, Sun Yat-sen University, Guangdong Guangzhou, 510655
  • Received:2024-04-07 Online:2024-05-25 Published:2024-09-03
  • Contact: LAN Ping E-mail:lanping@mail.sysu.edu.cn

Abstract:

Early rectal cancer is defined as any size of rectal epithelial tumor with infiltration depth limited to the mucosa and submucosa, regardless of with or without lymph node metastasis. Local resection is one of the main treatment methods for early rectal cancer without local lymph node metastasis. The development of endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), transanal endoscopic microsurgery (TEM), and transanal minimally invasive surgery (TAMIS) has brought more options for the treatment of early rectal cancer. About 8%-12% of early rectal cancer patients have local lymph node metastasis and therefore still require total mesorectal excision (TME). The current guidelines recommend that early rectal cancer with high-risk pathological features requires additional salvage radical surgery. Various minimally invasive and anal sphincter-preserving surgical techniques, such as natural orifice specimen extraction surgery (NOSES), transanal total mesorectal excision (TaTME), intersphincteric resection (ISR), and conformal sphincter-preserving operation (CSPO), have better achieved the goal of anal sphincter preservation and anal function preservation. The overall prognosis of early rectal cancer is good, but full-process surveillance is equally important. With the innovation of early diagnosis, early treatment and full-process surveillance, the development of endoscopic and surgical techniques will further improve the standardization of diagnosis and treatment for early rectal cancer.

Key words: Early rectal cancer, Local resection, Radical surgery, Full-process surveillance

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